MEDICARE: TINA M THOMAS, DMD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1770276248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TINA M THOMAS, DMD, PA

Provider Business Mailing Address
First Line	:	5935 US HIGHWAY 27 N STE 103
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-1200
Country	:	US
Telephone Number	:	863-382-0888
Fax Number	:

Provider Business Practice Location Address
First Line	:	5935 US HIGHWAY 27 N STE 103
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-1200
Country	:	US
Telephone Number	:	863-382-0888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TINA THOMAS
Credential	:	DMD
Telephone Number	:	863-382-0888

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	05/31/2023

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